The change of epicardial adipose tissue characteristics and vulnerability for atrial fibrillation upon drastic weight loss

Adipocyte. 2024 Dec;13(1):2395565. doi: 10.1080/21623945.2024.2395565. Epub 2024 Sep 9.

Abstract

Background: Obesity increases the risk of atrial fibrillation (AF). We hypothesize that 'obese' epicardial adipose tissue (EAT) is, regardless of comorbidities, associated with markers of AF vulnerability.

Methods: Patients >40y of age undergoing bariatric surgery and using <2 antihypertensive drugs and no insulin were prospectively included. Study investigations were conducted before and 1y after surgery. Heart rhythm and p-wave duration were measured through ECGs and 7-d-holters. EAT-volume and attenuation were determined on non-enhanced CT scans. Serum markers were quantified by ELISA.

Results: Thirty-seven patients underwent surgery (age: 52.1 ± 5.9y; 27 women; no AF). Increased p-wave duration correlated with higher BMI, larger EAT volumes, and lower EAT attenuations (p < 0.05). Post-surgery, p-wave duration decreased from 109 ± 11 to 102 ± 11ms. Concurrently, EAT volume decreased from 132 ± 49 to 87 ± 52ml, BMI from 43.2 ± 5.2 to 28.9 ± 4.6kg/m2, and EAT attenuation increased from -76.1 ± 4.0 to -71.7 ± 4.4HU (p <0.001). Adiponectin increased from 8.7 ± 0.8 to 14.2 ± 1.0 μg/ml (p <0.001). However, decreased p-wave durations were not related to changed EAT characteristics, BMI or adiponectin.

Conclusion: In this explorative study, longer p-wave durations related to higher BMIs, larger EAT volume, and lower EAT attenuations. P-wave duration and EAT volume decreased, and EAT attenuation increased upon drastic weightloss. However, there was no relation between decreased p-wave duration and changed BMI or EAT characteristics.

Keywords: (epicardial) adipose tissue; Adipokines; adipose remodelling; atrial fibrillation; bariatric surgery.

MeSH terms

  • Adiponectin / blood
  • Adiponectin / metabolism
  • Adipose Tissue* / metabolism
  • Atrial Fibrillation* / metabolism
  • Atrial Fibrillation* / physiopathology
  • Bariatric Surgery
  • Body Mass Index
  • Epicardial Adipose Tissue
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / metabolism
  • Pericardium* / metabolism
  • Pericardium* / pathology
  • Prospective Studies
  • Weight Loss*

Substances

  • Adiponectin

Grants and funding

Dr. E. Meulendijks has been supported by an MD-PhD 2016 grant from the University of Amsterdam. Prof. de Groot has been supported by research grants from Abbott, AtriCure, Boston Scientific, Bayer, Daiichi Sankyo, Johnson & Johnson, and Medtronic Servier and has received consultancy fees from AtriCure, Bayer, Daiichi Sankyo, Johnson & Johnson, and Medtronic (outside the submitted work). Dr. Tim A.C. de Vries reports nonfinancial support from Daiichi Sankyo and speaker fees from Bristol Myers Squibb, both outside the submitted work.None of the above funders were involved in this submitted work.Abbott Fund AtriCure Boston Scientific Corporation Daiichi Sankyo Europe Johnson and Johnson Medtronic Europe.